Corneal surgery

Dr. Barnhorst is not only a board-certified ophthalmologist but he is a fellowship-trained cornea specialist. He has trained with and worked with many leading corneal surgeons in the United States and has extensive training and experience in many types of corneal surgery. As with LASIK and refractive surgery procedures, it is critical for patients with corneal disease to have a chance to be personally examined by a cornea specialist who takes the time to get to know them and their unique circumstance(s) in order to determine which, if any, corneal procedure may be best for them. In this way is a patient most likely to get the best surgical outcome.

At Barnhorst Eye Associates, we are dedicated to providing the latest in corneal surgery and techniques while also insuring that we are providing proven, safe procedures which are likely to benefit the patient and achieve the best long-term visual outcomes. We don't necessarily provide every new procedure that is introduced in the ophthalmology field if we don't feel it is likely to provide patients with safe, long-term results. Obviously no surgery is guaranteed to succeed or be without the potential for complications, but Dr. Barnhorst strives to provide the latest technology and surgical techniques which are available which have proven over time to give the best and safest long-term results.

Procedures

Corneal Transplant

In traditional corneal transplant surgery (also known as Penetrating Keratoplasty or PKP), a patients cloudy or diseased cornea is removed and a donor cornea (taken from a person who has donated their organs) is used to replace the diseased cornea. Very small sutures (stitches) are used to hold the donor cornea in place while it heals and these sutures are then gradually removed in the months following surgery as the donor cornea heals into place. Removing these sutures helps to reduce the astigmatism that frequently occurs after corneal transplant surgery. The most common eye diseases that lead to the need for corneal transplant surgery are: keratoconus, Fuch's corneal dystrophy, bullous keratopathy, trauma, and post-infectious corneal scars. Patients who have undergone corneal transplant surgery are at lifelong risk for rejection of the transplant and must agree to maintain good communication with their corneal surgeon.

DSAEK/DLEK

A very promising new type of corneal transplantation has been introduced for those patients with primarily endothelial corneal disease (patients with corneal diseases such as Fuch's dystrophy and bullous keratopathy). In these procedures, only the inner, endothelial layer of the patient's cornea is replaced by a similar layer of corneal donor tissue. This allows for not only a safer surgical procedure but much quicker visual recovery and less post-operative discomfort. Additionally, the likelihood of post-operative transplant rejection may be less. While these procedures are newer, Dr. Barnhorst has investigated the procedure and found it to be generally safe with good long-term results and much quicker visual recovery than traditional corneal transplant surgery. For those reasons, he is now offering DSAEK (Descemet's Stripping Automated Endothelial Keratoplasty) to his patients with corneal endothelial disease who require corneal transplant.

PTK

The same laser that is used to perform LASIK or PRK laser eye surgery has also been approved by the FDA to treat certain superficial (surface) corneal diseases due to scars or corneal dystrophies. In a procedure called PTK (Phototherapeutic Keratectomy), the excimer laser is used to gently and precisely remove scars or irregularities in the superficial layers of the cornea. The laser enables us to remove these scars or irregularities very precisely and create a much smoother and regular surface than if we were to remove such scars or irregularities by more traditional methods such as by hand with a scalpel or burr. Because the nature of corneal scars can vary widely between patients, it is very important that patients have the PTK procedure performed by an experienced corneal surgeon who is familiar with various PTK techniques and can tailor the laser treatment to the patient's unique corneal problem. There is an art to performing PTK and, as an experienced corneal surgeon who has been performing PTK procedures since 1996, Dr. Barnhorst has the experience and knowledge to create the right customized treatment for each patient.

Pterygium Surgery

A pterygium is a small web-like vascular growth that occurs typically around the nasal or temporal aspect of the cornea (that is at the 3 o'clock or 9 o'clock positions if there were clock-hour marks around the cornea). A pterygium typically occurs due to years of sun and/or wind exposure to the surface of the eye and can lead to chronic redness or irritation of the eye as well as decrease vision. Once a pterygium leads to sufficient irritation or decreased vision to bother a patient, surgery to remove the growth can be performed on an outpatient basis. There is typically a mild degree of discomfort for the week following the surgery but Dr. Barnhorst has recently begun using a newer technique which further minimizes pain and discomfort after surgery and leads to a very low level of recurrence.